Impact of the HIV/AIDS Epidemic on the Health Sectors of Developing Countries

10 Impact of the HIV/AIDS Epidemic on the Health Sectors of Developing Countries MEAD OVER A ny discussion of the impact of acquired immune deficiency syndrome (AIDS) on health care systems must distinguish between treatment of the opportunistic illnesses associated with AIDS and treatment directed at the underlying cause, namely, the human immunodeficiency virus (HIV). Treatment of opportunistic illnesses can alleviate suffering but typically extends life by only months. Treatment that controls the HIV in the patient’s body, called antiretroviral therapy or ART, can be much more successful, adding years to life expectancy. Before 2001 the annual cost of a three-drug combination ART regimen for a patient in a poor country was approximately $10,000 to $25,000. Only a few of the richest developing countries, such as Brazil and Thai- land, could attempt to finance ART for their AIDS patients. In most developing countries the only patients receiving ART were the very rich or those who had access to rationed, low-price supplies through a variety of pilot or research projects. Most other patients had little access to ART, and thus the impact of AIDS on these countries’ health systems could be understood simply by considering the demand for and supply of the treatment of opportunistic illnesses. Since 2001, however, generic versions of ART medications have become available in poor countries at a cost of as little as $150 a year. In 2001, at the Doha round of World Trade Organization (WTO) discussions, both industrial and developing countries negotiated and signed a Declaration on Trade-Related Aspects of Intellectual Property Rights (TRIPs) and Pub- lic Health, which confirmed provisions already implicit in earlier WTO 311

Impact of the HIV/AIDS Epidemic on the Health Sectors of Developing Countries

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